HomeMy WebLinkAboutBuilding Permit ApplicationAil APPLICABLE INFO MUST BE COMF'tt i'tD FOR APPLICATION TO BE ACCEPTED
Date: .1_. �T_ Permit Number: - 5�
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
PROFQSED INPR01/EMENT LOCATLON`
- - RECEIV15-I
Building Permit Application MAY 31 2019
ST. Lucie County, Permitting
Commercial Residential_
Address: 2101. ErOOKLihe, Avf
PropertyTax ID #: 1301- I (- O 1ZQ 3 Lot No. �S
Site Plan Name: �'� Block No.
Project Name: _j � we cd Pa�
: P: ILeD DESCRIPTION OF WORK:
LCONSTRUC-TION`INFORMATION: _ -
Additional work to be performed under this permit -check all that apply:.
., Mechanical _ Gas Tank _ Gas Piping KShutters %f Windows/Doors
Electric Plumbing _ Sprinklers _ Generator 44-
Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _� (o 09
/J �
Cost of Construction: $ � " q, 91 o Utilities: —Sewer 7L Septic Building Height:
OWNER/LESSEE; . ,
CONTRACTOR:
Name l_-) C
Address:
Name:
Company:
Address:330o 01
City: Qz-) C �S�c� State: —
Zip Code: QtI Li (0
City: Go State: MC, -
Phone No.
Zip Code: 0'14(C) ` " -Aa ,3
E-Mail: t.reti, •Dai7Qcc12,�i�arcerc�
Phone No
E-Mai_ a - . a
Fill in fee simple Title Holder on n_ ex_t page.( if different
from the Owner listed above)
State or County License
it value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
iA : TRU 9. 1EN ( SUPPLEMENTAL PLE E TA- 'CdN.S' CT16'1
"W'INIFORMATIOW
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City; State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: ?C Not Applicable
BONDING COMPANY: 14 Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIt: Application is hereby made to obtain a permit to do the work and installation as Indicated.' -
I certify that no work or installation his commenced priorto the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws that
or and covenants may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
'in consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded And posted on the jobsite
before the first inspection. If you intend to obtain financing, con It with �1ran attorney before
commencilig work.or rerording your Notice of CommencemLM21 )vr
J-L
Signature of q0er/ Ltysee/Contractor as Agent for Owner
Signature o trac r !tense Holder
STATE OF FLORIDA
STATEWF LO DA
COUNTY OF
COUN OF
0
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _1_.day of 20A by
this hLday of L4 20J _q_ by
4/ttd6 ]SUMeY Sr.
Name of person making statement.
Name of person ma ing statement.
Personally Known X OR Produced identification
Personally Known X OR Produced Identification
Type of identification
Type of Identification
Produced
Produced
01
(Signature of
--l-laiii.6ima sifirm
naotol
(Sig f Nota
Commission N
Commis
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MY COMMIS510t" 7558
EXPI S:Au ustr5rol,22
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BAYLIE EIKMEIER
tate F
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Commission No. A State of Flori Sm)ary Public
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Bonded Thiu Notary Public Underafts
iss
!�sion�# GG 235138
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My Co m m sio Expires
MY Commission Expires
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS VEGETATION SEATURTLE MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 9/2b/18
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